This form for use in litigation against an insurance company for bad faith breach of contract. Adapt this model form to fit your needs and specific law. Not recommended for use by non-attorney.
Subrogation For Aetna In Palm Beach
Category:
State:
Multi-State
County:
Palm Beach
Control #:
US-000279
Format:
Word;
Rich Text
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FAQ
You can submit a claim online through the member website at myaetnasupplemental. Or you can download a paper claim form or request one be sent to you by our customer service and mail it to: Aetna Voluntary Plans, PO Box 14079, Lexington, KY 40512-4079.
You must file claims within 180 days of the date you provided services, unless there's a contractual exception.
If you've had a health treatment or disability claim denied by Aetna, it could be because: The procedure is considered cosmetic (not medically necessary) Your doctor is out of network or doesn't participate in the plan. Your plan doesn't cover your medical condition.
Aetna Inc. Since November 28, 2018, the company has been a subsidiary of CVS Health. Aetna Inc. Aetna's headquarters in Hartford, Connecticut.
Aetna Signature Administrators® is the brand name for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).
You can submit claims online or resubmissions through ConnectCenter.
Use the CPT Code 99404 in order to indicate the sessions is billed under EAP.
You can submit corrected and voided claims electronically. Just include the originally assigned claims number. Include a procedure code description for codes not otherwise classified or listed. Ask your vendor where to include this information.
EAP claims should be submitted through Provider Express or on a CMS-1500 claim form using the standard "HJ" modifer in section 24D.
Where can I go to check the status of a claim? You can check claim status: By using Aetna Voice Advantage® (AVA), our interactive telephone self-service system. By registering or logging in to your secure site.